Ketamine treatments are pretty expensive at a clinic. If you wanted regular Ketamine doses for depression (maybe like 1 a month?), I would just buy some online and insufflate it. Safer than a needle and just as effective.
PS: Chronic Ketamine use destroys your urinary tract (I know people that wet the bed every night from too much of the stuff). Also, it might cause brain damage, but no one is really sure.
If you read my comment. I'm suggesting that you don't inject ketamine and instead you should snort it. I'm not suggesting that snorting black market ketamine is safer than a clinic.
Though, ketamine is pretty damn safe, and it's rarely adulterated on the black market. In powder form, it forms crystals so it's hard to fake.
A priori, you can always say that something regulated is more safe than something not. But if you're a savvy consumer, you can significantly mitigate or eliminate that risk.
Exactly. Street ketamine powder is often heavily cut. If I had to buy illegally for some reason, I would only consider buying sealed vials, and I'd probably still have them tested. My ketamine doctor has worked with patients who used to buy on the street, and they brought in "ketamine" that was the wrong color, had flecks of different colors in it, etc.
I'm not sure what point you are trying to make. I didn't say anything about doing it for recreational consumption.
I'm suggesting that if you can't afford a Ketamine clinic: a) Ketamine is generally unadulterated on the black market b) if it is adulterated you can often tell c) unless a professional is administering it, you probably want to snort it and finally d) snorting Ketamine should have roughly the same effects (anti-depressant or otherwise) as injecting it.
Are you arguing in good faith? The proposal is to buy ketamine online and snort it IF you cannot afford to do it in a clinic because (1) ketamine as a pure drug is pretty safe if you don't use it routinely (2) snorting is safer than IV. The topic is still to use ketamine against suicidal ideation. This has been repeated to you twice, please try reading better before arguing with people.
The chronic users are on very very high doses . It does happen on users who take low doses but much less compared to others . U need to flush ur system with liqueds according to harm reductions guides
> I would just buy some online and insufflate it. Safer than a needle and just as effective.
Insufflation is only "just as effective" if your goal is to get an intense psychedelic high.
If your goal is a strong antidepressant effect, insufflation is extremely less effective than IV-drip-over-40min. This isn't just my opinion, it's the consensus opinion of ketamine docs across the world.
Insufflation helps you for a few minutes to a few days, IV drip method works for 3-6 weeks.
What biological mechanism would make this the case? Are you saying it has to do with bio-availability? Half-life? Onset? Duration?
What about IM? What about rectal administration? How about sublingual? Are there any papers suggesting that IV is somehow quantitatively different from the aforementioned methods?
My personal experience is that IM, IV, and snorted all made me feel better for maybe a period of 2 weeks. I wasn't necessarily doing a "clinical" dose, whatever that means (maybe 25-75mg of IM or IV and 100-250mg snorted), but the anti-depressant effects all seemed comparable.
A drug crossing the blood-brain barrier is a drug crossing the blood-brain barrier. There should be no difference in administration if we are talking about weeks to months later.
The effectiveness of ketamine for depression is all about the state it puts your mind in. This is obvious because the drug itself has totally left your body shortly after administration, but the effects can last much longer. In this respect you can think of it as your mind actually healing itself, by being induced to by the ketamine, rather than the ketamine itself impacting your brain's structure. This is different from most conventional psychiatric medicine where the drugs need to build up and remain in your system over very long periods of time to be effective.
Optimizing the dose & duration to get your mind into that state, and for the right amount of time, makes a huge difference in how long the effects last. This is why I prefer using an actual doctor with ketamine depression treatment experience, because they have experience figuring out the right dose & duration for you.
Ketamine is an off label treatment. Many of the practitioners aren't even psychiatrists. There are nurses, anesthesiologists, and pain specialists that do this as a side gig to make money. Your statement reads like we should put a lot of trust in these people when it's actually the opposite. One of the biggest clinics just hired a CEO to expand their business.
The time that the effect lasts is variable. A patient may need an infusion every week. That's $26,000 a year in some cases.
I actually had a doctor tell me that the infusions last 6 months.
Yes, I am indeed saying you should trust the opinions of people with medical training and experience. Especially doctors that have been treating depression with ketamine for years. Whether or not they're an anesthesiologist or one of the handful of people in the entire world that are both an anesthesiologist and a psychiatrist. (All of my ketamine docs require you to also see a psychiatrist, so that profession is still completely involved for me.)
My previous doctor runs a monthly group meeting where patients get together to discuss their experiences. The vast majority of attendees had positive experiences. So even if you don't trust the doctor, you can trust the living proof of positive outcomes. Sure, you could say that the group self-selects for positive outcomes, but no one claims this treatment is 100% effective, either.
My doctor has been treating ketamine for years and he says that these doctors you are talking about are screwing patients. My doctor is more reputable: A) he has clinical research experience and B) he isn't making any more money than he would on other treatments for depression.
Yes, ketamine docs want you to see a psychiatrist because they don't want to deal with you. It's about the money and having as little responsibility as possible.
A support group to discuss experiences? That sounds like it would encourage a placebo effect.
Which doctors, exactly, are you referring to when you say "these doctors you are talking about"?
What makes you think both my doctors don't have clinical experience? (I never stated, you never asked. As it turns out, they both do.) You've turned this conversation into a pissing match about whose doctor is best, which is too petty for me, so this will be my last post in response to you.
> Many of the practitioners aren't even psychiatrists
> ketamine docs want you to see a psychiatrist because they don't want to deal with you
So a ketamine doc that isn't a psychiatrist is bad, in your opinion. And also any ketamine doc who realizes that the situation he's treating requires psychiatry for optimum outcome, recognizes they lack said experience, and makes you go to someone with that experience, is also bad? I'm sorry, but your posts reek more of an anecdotal agenda rather than... science. So, I'm done.
I don't have an opinion on the subject in either direction, but I was struck by this sentence -
"ketamine doc who realizes that the situation he's treating requires psychiatry for optimum outcome, recognizes they lack said experience, and makes you go to someone with that experience, is also bad?"
The "ketamine doc" you're advocating people should see to treat their persistent psychological conditions such as PTSD or Depression, has no experience or background in treating any psychiatric/psychological conditions at all (and they get credit for recognizing that!).
Given the above, what service does the "ketamine doc" provide other than selling the ketamine? Like, what difference does it make that they are a doc? The access to an IV drip? The ability to google dosage? I can do renal function work ups with my family physician.
I'm genuinely confused on what value they add beyond a street dealer (assuming identical substance quality, home tests do exist).
Which is to say, a doctor is generally understood to be something beyond a prescription pad and should actually be involved in the treatment he's supposedly providing.
Also, I feel like this "treatment" model is highly likely to incentivize profit-maximizing-pill-pushing clinics rather than compassionate therapists.
The value the ketamine doc (in my case, both docs have been anesthesiologists) provides, that a psychiatrist doesn't, are:
(1) Safely starting an IV on you
(2) Monitor your heart rate, O2, bp levels during the infusion - sometimes people have problems during infusions, I've never had one, but I feel safer having these treatments knowing my vitals are being monitored
(3) Training to know how to solve emergency health issues you may have during the treatment. I personally value this on-the-spot emergency medical knowledge very highly, but if you don't then I can understand why you might question the value. I am completely and utterly helpless during an infusion, if anything bad happens to me, I will be utterly unable to help myself, even a tiny bit.
(3) Access to pure/safe ketamine
I've never known, or heard of, a psychiatrist that will do all this. They very well may exist but not in my area.
This is not strictly true. Chronic ketamine ABuse can cause urinary tract problems. The doses and frequency used in a clinical session emphatically do not cause this problem. Ketamine has been in regular use since 1970 for a wide range of medical purposes. It's also been on the WHO Essential Medicines List since 1985.
tl;dr - don't need to worry about urinary tract issues unless you're using the drug (1) recreationally; (2) irresponsibly
I only know hearsay, but the issue effects those sniffing 2-3+ grams a day, every day for extending periods. The ketamine causes internal scarring of the bladder / urinary tract (not sure which or if either), that scarring stops the organ (maybe wrong word) from expanding and contracting.
So you feel like you need to piss regularly, but only a few drips come out. The damage can get so severe bladder gets removed.
At the lesser end of the damage is agonising stomach cramps, no idea what the cause of this is.
source: spent too long in the uk freeparty rave scene when ketamine was legal and people assumed it was completely safe due to lack of come down. Too many people ended up with severe ketamine addictions and many have to know piss through a bag
Though there hasn't been much research on it, I suspect that methoxetamine (MXE) might have the same anti-depressant effects as ketamine. Also, it doesn't have the urinary tract issues.
Also, it's much much cheaper on the black market than ketamine. We're talking around 1000 (recreational) doses for $20. Compared to say 10 (recreational) doses of ketamine for maybe $50?
>Also, it's much much cheaper on the black market than ketamine.
What is it like to still be living in 2014? MXE hasn't been manufactured in any significant quantity since China banned it years ago. The stockpiles that remained have been stretched out at high prices and have significantly degraded over the years, people are reporting needing 2-3x the previous dose.
I guess I don't know what I'm talking about anymore. Stopped all that stuff awhile ago. Probably shouldn't be giving advice on the internet about it anymore I suppose..
MXE does. So does 2-Fluorodeschloroketamine, deschloroketamine, and several others. The issue is once you step off the PCM chain you have hider chance of a side effect of mania.
MXE does have the same bladder issues, but is taken as a smaller dose so it takes longer to happen.
2-3+ grams a day is crazy. Ketamine from a legit clinic is around 100mg give or take based on body weight, once per 3-6 weeks. If you increase the dose of any safe drug by that many orders of magnitude, yes, your body will be harmed!
PS: Chronic Ketamine use destroys your urinary tract (I know people that wet the bed every night from too much of the stuff). Also, it might cause brain damage, but no one is really sure.